Social Anxiety Disorder (SAD) is considered the most prevalent anxiety disorder with the highest disease burden amongst anxiety disorders. Despite available effective treatment with Cognitive Behavioral Therapy, a majority of individuals with SAD do not seek treatment and many drop out when confronted with elements of exposure. Several studies highlight the many advantages virtual reality exposure holds over in vivo exposure. In this study, we investigate the added effect of real-time biofeedback during virtual reality exposure.

The current study is part of a large scale study called VR8. The current study aims to develop and evaluate the feasibility of a VR-biofeedback-intervention for adults with mild to severe social anxiety disorder, before continuing randomized controlled trials.

Data from semi-structured interviews and surveys will be compared to biodata collected during VR exposure. Participants include a minimum of (n=10) patients and (n=10) clinicians from the Mental Health Services in the Region of Southern Denmark. Surveys include questionnaires used for assessment of anxiety symptoms, usability of technology, and presence in the virtual environment. Collected biodata includes heart rate variability and electrodermal activity. Behavioral markers include eye-gaze. The findings will be analyzed and discussed in a mixed methods design.

The study is ongoing. Preliminary results will be available at presentation.

Successful development and implementation of a biofeedback-informed virtual reality exposure intervention may provide increased reach for patients and individuals who would have otherwise not sought- or dropped out of regular treatment, as well as inform the clinician on how to proceed during virtual exposure.

Prof. Stephané Bouchard is consultant to and own equity in Cliniques et Développement In Virtuo, which develops virtual environments, and conflicts of interests are managed according to UQO’s conflict of interests policy; however, Cliniques et Développeme

No significant relationships.

Unpredictable risks of COVID-19 morbidity and mortality make people suffer from threats and fears. Are there any psychological personality traits that correlate with a decrement in such feelings?

To specify the relationship between psychological characteristics of time perspective, hardiness and COVID-19-related life threat.

We used Zimbardo Time Perspective Inventory, Maddi Hardiness Scale and a 17-point Attitude towards COVID-19 Questionnaire to question 327 Russian university students on social networks. The survey was carried out in the second half of May 2020 in the period of increasing COVID-19 morbidity and mortality rates. The mean age of the respondents was 21.24±2.84; most of them were females (61.16%).

The survey showed that every fifth respondent had a high level of COVID-19-related life threat (21.10 %). At the same time, every tenth of the respondents (10.09%) saw no threat to their life in the situation of a fast spreading dangerous novel coronavirus infection. According to the correlation analysis, decrement in feeling personal threat related to the spread of COVID-19 was directly associated (p<0.05) with low indicators on the scales of Negative Past (r=0.16), Hedonistic Present (r=0.13) and Fatalistic Present (r=0.17). Certain inverse relation was found between the level of COVID-19 related life threat and such indicators as psychological hardiness – commitment (r=-0.16), and challenge (r=-0.23).

Dispositional orientation to the present and future, as well as psychological characteristics of hardiness may mediate COVID-19 related life threat; therefore, these may be used as a possible basis for preventing stress and mental disorders in population.

Bipolar disorders (BD) are associated with a high degree of impulsivity especially during manic and depressive episodes. However, there is little information on impulsivity during remission phase.

Our objective was to assess impulsivity in patients with BD in remission compared to healthy controls (HC).

This was a comparative, cross-sectional and analytical study, conducted in the outpatient psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia), from July to September 2019, among 30 patients with BD in remission compared to 34 HC. Data were collected on a pre-established questionnaire. Impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11).

Mean ages of BD patients and HC were 44.17 and 40.1 years, respectively. The sex ratio was 1.7 in BD patients and 0.9 in HC groups. Age of onset of BD was 30 years. Impulsivity scores of the BD patients were higher than HC on total (66.27 vs 53.53) and three subscales measures; motor (21.83 vs 16.15), attentional (15.83 vs 13.53) and non planning impulsivity (28.93 vs 23.71). High degree of impulsivity was noted in 33.3% of BD patients. BD patients scored significantly higher than the HC on total, motor, and non planning impulsivity scores (p = 0.001; p = 0.001; p=0.000, respectively)

Our study found that patients with BD had a high degree of impulsivity outside the critical period compared to healthy individuals. Would this impulsivity be a vulnerability marker to the risk of early onset of the disease or the risk of its relapse?

Pandemic is accompanied by “infodemic” that is related to higher anxiety (Moghanibashi-Mansourieh, 2020; Roy et al., 2020; Huang, Zhao, 2020). We suggest that indefinite and stressful situation of pandemic provoke magical thinking leading to lower adherence with recommendations for self-isolation.

The aim was to reveal the structure of beliefs about reasons, manifestation and consequences of coronavirus and their relationship with magical thinking, anxiety and COVID-19-related behaviour.

In April 2020 (2-3 weeks of self-isolation regimen) 402 adults aged 18-64 years old filled checklist including beliefs about pandemic (based on the model of Leventhal et al., 2003), Magical Ideation Scale Eckblad, Chapman, 1983) as well as scales measuring anxiety and protective behaviour in pandemic and monitoring of information about coronavirus (Tkhostov, Rasskazova, 2020).

Factor analysis revealed three groups of radical beliefs about coronavirus (48.6% of variance, Cronbach’s alphas .62-.75). Belief about the particular meaning of coronavirus was associated with the magical thinking (r=.21), less anxiety about infection (r=-.19) and poorer adherence to self-isolation (r=-.26). Belief in the negligence as a cause of coronavirus was more typical for those with better adherence (r=.18) while catastrophic beliefs about the consequences of pandemic were related to frequent monitoring of the information about the pandemic (r=.24), and anxiety regarding future negative consequences of the pandemic (r=.46).

Dysfunctional beliefs about coronavirus could be a factor of poorer adherence related to magical thinking and could be addressed in psychological interventions. Research is supported by the Russian Foundation for Basic Research, project No. 20-04-60072.

No significant relationships.

Individuals with bipolar disorder often have a ‘predominant polarity’ (e.g. depressive or manic) that characterizes the majority of episodes over the course of the illness. Genome-wide association studies have suggested a relationship between genetic risk and phenotypic heterogeneity in bipolar disorder. However, to date, no study has directly examined the association between polygenic liabilities and predominant polarity in bipolar disorder.

To estimate the associations between the polygenic risk score for major depressive disorder (PRS-MD), bipolar disorder (PRS-BD) and schizophrenia (PRS-SZ), and predominant polarity among individuals with bipolar disorder in hospital-based settings in Denmark.

The study sample will include all individuals from the Initiative for Integrated Psychiatric Research (iPSYCH2015) sample who received a diagnosis of bipolar disorder and were successfully genotyped (approximately 3,400). Information on polarity will be computed based on data from the Danish Central Psychiatric Research Register. PRS variables will be generated using the most recent results from the Psychiatric Genomics Consortium. Odds ratios for the associations between PRS variables and polarity will be estimated using logistic regression.

We hypothesize that PRS-MD will be highest among the predominantly depressed patients, that PRS-BD will be highest among those with predominantly manic/mixed episodes, and that PRS-SZ will be highest among those who experience psychotic mania or psychotic bipolar depression. The results will be shown at the conference.

A finding of association between genetic liability and predominant polarity in bipolar disorder could pave the way for stratification on genetic liability in future treatment studies and in clinical practice.

No significant relationships.

The article is devoted to the main methodological problems of qualitative research in the psychology of culture. Methods of ethnographic (field) observation were borrowed by psychology from social and cultural anthropologists in the first half of the twentieth century, and in modern research practices there is a special ethnographic direction that claims to analyze behavior and lifestyle in various subcultures and communities.

The purpose of this study was to identify the key cross-cultural difference in coping behavior of respondents from Moscow and Tashkent.

The methodological basis of the research was the thematic analysis of narratives and free-form interviews. The sample was N = 60 (residents of Russia and Uzbekistan age 17-39).

The results of thematic analysis of narratives and free-form interviews of respondents from Moscow and Tashkent allow us to conclude that the key cross-cultural difference in coping behavior is the degree of its individualization: representatives of Uzbek culture are focused on receiving support and care from significant Others, and not on independent internal work (unlike Russian respondents). At the same time, they are not satisfied with the traditional prescriptions that come from the family environment, which forces them to coping practices that go beyond the boundaries of normative social (often religious) ideas.

This can be interpreted from the point of view of the process of modernization of Uzbek culture, which is gradually becoming individualistic, and the latter circumstance requires the construction of flexible coping strategies in the situation of social and cultural changes.

No significant relationships.

Internet addiction (IA) is a significant public health issue among adolescents. There is considerable evidence that IA is associated with various psychosocial harms.

The aim of this study was to measure the prevalence of internet addiction among secondary school.

This cross-sectional study was conducted among 152 students enrolled in secondary school. The participants had filled the Internet Addiction Test of Young and a data file regarding the socio-demographic information, physical and information about the internet access and use.

The sample consisted of 90 males and 62 females with a mean age of 13.14 ± 1.2 years. The majority of participants had their own smartphone (83.6%). The average duration of connection among participants was 5.3 hours per day. The prevalence of IA was 14,5%. Results showed that 46,8% feel their internet use significantly hinders their family relationships. Twenty participants (13,2%) reported that they connected to the internet while they were in classroom. The prevalence of IA was higher among boys than girls (p= 0.018). There was, also, a significant relation between IA and having academic difficulties (p=0.037).

The prevalence of IA is elevated in Tunisia. Many negative consequences are identified. Urgent measures should be taken to counter the problem.

In response to the treatment gap for anxiety and depressive disorders, psychological treatments with innovative modalities and high implementation potential are essential. Internet CBT (iCBT) is a cost/effective approach that could improve access to a low-intensity evidence-based CBT intervention.

To assess the feasibility and acceptability of the French adaptation of the physician-prescribed six-lesson This Way Up transdiagnostic iCBT program for mixed anxiety and depressive disorders developed in Australia.

Feasibility study with pre- post-intervention evaluations, including an embedded qualitative study in Family Medicine Groups (Quebec, Canada). Inclusion criteria comprise a family physician diagnosis of Major Depression, Panic Disorder, Agoraphobia, Social Anxiety Disorder or Generalized Anxiety Disorder. Primary self-reported outcomes: PHQ-9 (depression) and GAD-7 (anxiety); secondary measures include diagnostic-specific scales and health service utilisation.

Family physicians (N=21) from five Family Medicine Groups prescribed iCBT to 45 patients (30 women, 15 men; mean age = 39.7), 31 initiated the program. To date, 20 patients completed 5 or 6 lessons, nine completed between 2 and 4. Intervention and post-treatment assessments are ongoing, results forthcoming. Results of semi-structured interviews with patients (N=15) and family physicians (ongoing) on iCBT acceptability indicate it is beneficial, practical and easy to use. Program adherence requires patient readiness and determination and could be fostered by motivational support from clinicians.

Results support this French iCBT program’s scaling-up potential to contribute to reducing the gap in evidence-based treatments for common mental disorders. Its implementation in primary care could improve the effectiveness, efficiency and equity to a rapidly accessible treatment.

Analytical-cathartic therapy (ACTA), a modern model of psychotherapy, the theoretical basis of which is the psychology of relations of V.N. Myasishchev. ACTA is intended for the treatment of emotional disorders; the study of the dynamics of clinical and pathopsychological characteristics has not been previously conducted.

To assess the dynamics of the clinical and pathological characteristics of patients with neurotic disorders, in whose clinical picture anxiety syndrome predominated, in the process of an individual ACTA.

A specially designed semi-structured interview, HARS, and the CGI (CGI-S - disease severity, CGI-I - improvement dynamics). The study group (N = 90) included patients with neurotic disorders, whose clinical picture was dominated by anxiety syndrome

AKTA course 12 sessions 3 times a week for 60 minutes. Psychopharmacotherapy during the period of psychotherapeutic treatment in patients was not carried out.

The study of ACTA was carried out before, after treatment and in the follow-up.

The overall decrease in the HARS score was 73.8% - the high success of the therapy in relation to the reduction of anxiety.

On the CGI-I scale - improvement from minimal to significant. On the CGI-S scale, no more than mild disease severity (p <0.01). The change in the CGI scale also indicates the success of the therapy.

As a result of the study, clinical indicators were determined, on the basis of changes in which in dynamics the success of the treatment can be assessed. ACTA allows to clearly reduce anxiety and improve the general condition of patients with neurotic disorders.

No significant relationships.

The bipolar disorder is characterized by instability mood. It normally happens in the middle-aged. In elderly patients with a first manic episode, you have to dismiss organic pathology.

To present an elderly patient with a first manic episode

A descriptive study of a clinical case and literature review

A 67-year-old man, married. Consulted Mental Health 5 years ago, about low mood after his early retirement. With no psychiatric treatment. Somatic antecedents: Acute myocardial infarction, hypertension and dyslipidemia. Came to the hospital accompanied by his son-in-law presenting rapid speech and thinking, bright clothing, risky behaviour, irritability, grandiosity deliration ideas and less sleep; being necessary a hospital admission. Blood and urine analysis: with no abnormalities. No toxics in the urine. Asenapine 20mg and Lorazepam 3mg were prescribed with clinical improvement. Brain CT: with no abnormalities. After that, Lithium 400mg per day was prescribed to avoid the induction of depression. Clinical judgement: manic episode. Bipolar disorder Type I

After dismissing somatic causes, the symptomatic treatment of a manic episode in older patients is on the same lines as the treatment for mania in young adults. 8-10% of psychiatric inpatients over age 55-60 years are diagnosed with bipolar disorder. Since there is an increase in the number of individuals living longer, an expected increase in the number of older adults who will be diagnosed with bipolar disorder. Older adults with bipolar disorder will increase in absolute numbers as well as the proportion of the general populations.

No significant relationships.

There is a limited literature available showing mental health burden among adolescents following cyberbullying.

Aim is to evaluate the association of low mood and suicidality amongst cyberbullied adolescents.

A study on CDC National Youth Risk Behavior Surveillance (YRBS) (1991-2017). Responses from adolescence related to cyberbullying and suicidality were evaluated. Chi-square and mix-effect multivariable logistic regression analysis was performed to find out the association of cyberbullying with sadness/hopelessness, suicide consideration, plan, and attempts.

A total of 10,463 adolescents, 14.8% of adolescents faced cyberbullying a past year. There was a higher prevalence of cyberbullying in youths aged 15-17 years (25 vs 26 vs 23%), which included more females to males (68 vs 32%).(p<0.0001) Caucasians (53%) had the highest number of responses to being cyberbullied compared to Hispanics (24%), African Americans (11%).(p<0.0001) There was an increased prevalence of cyberbullied youths with feelings of sadness/hopelessness (59.6 vs 25.8%), higher numbers considering suicide (40.4 vs 13.2%), suicide plan (33.2 vs 10.8%), and multiple suicidal attempts in comparison to non-cyberbullied.(p<0.0001) On regression analysis, cyberbullied adolescence had a 155% higher chance of feeling sad and hopeless [aOR=2.55; 95%CI=2.39-2.72], considered suicide [1.52 (1.39-1.66)], and suicide plan [1.24 (1.13-1.36)].

In our study, cyberbullying was associated with negative mental health outcomes. Further research is warranted to examine the impact and outcomes of cyberbullying amongst adolescents and guiding the policies to mitigate the consequences.

No significant relationships.

Music has been said to be emotion’s language. Research confirms a link between music structure and triggered emotions.

To assess the relationship between selected music excerpts and the emotions trigged, in order that the former will be used in future research.

An anonymous study was performed in April 2019 on 65 subjects of both sexes, aged 19- 33 (mean=21,09; SD=3,05).Subjects listened 4 excerpts of music, believed to be related either to excitement or to calmness, and answered to a questionary on emotion’s triggered by each exposure.

Regarding to the music excerpts that were believed to induce excitement 80% of the subjects mentioned exciting emotions, 78% enjoyed the music while 78% didn’t knew them. For the ones that were believed to induce calmness 69% of the subjects mentioned calm emotions, 84% enjoyed the music and 62% didn’t knew the music. In an excerpt of music related to calmness, we observed association between knowing the music and the emotion trigged (p=0,027). The triggered emotion responses were independent of liking the music (P>0,05).

In our study, independent of liking the music, the participants reported to have perceived the expected emotions triggered by musical excerpts, showing this to be a phenomenon related to music structure. Calmness perception may be also influenced by previous knowledge of the music and related experiences. The role of individual perceptions will be looked for in following studies.

No significant relationships.

Inflammatory bowel disorders (IBD) are chronic diseases with severe course. In this regard, research aimed at identifying adaptive behavior styles potentially significant for individual resilience to disease-related stress is of particular importance

The study population included 45 patients with the inflammatory bowel disorders: 19 male, 26 female (mean age 36,0±4,8), whose clinical and experimental psychological characteristics were studied.

The following methods were used: ‘Life Style Index’ by R. Plutchik, Н. Kellerman, ‘Ways of Coping’ by R. Lazarus, S. Folkman.

The experimental psychological study revealed interdependence of psychological defense mechanisms and coping behaviors. Thus, in female patients, such psychological defense mechanisms as ‘denial r=-0,51’ and ‘compensation г=-0,43’ showed negative correlation with ‘planning problem-solving’ coping strategy and positive correlation with such coping strategies, as ‘escape - avoidance г=0,38’ and ‘confrontation г=0,32’ р<0,05; in male patients, such psychological defense mechanisms as ‘regression г= -0,41;’ and ‘displacement г= -0,30’ demonstrated negative correlation with ‘planning problem-solving’ and ‘exercising self-control’, but positive correlation with such coping strategies, as ‘escape - avoidance г= 0,34’, ‘confrontation г= 0,40;’, р<0,05. Maladaptive attitude towards disease correlated with avoidance reactions in both male and female patients, which is indicated by the central rank position in disease coping structure of ‘confrontation’ coping strategy М=69,3±0,1, along with insufficient utilization of ‘planning problem-solving’ coping strategy М=39.3± 0,1, р< 0,001.

The identified manifestations of psychological maladaptation in both male and female inflammatory bowel disorder patients are moderately pronounced, but require psychotherapeutic correction

Pain, fatigue and anxiety are common features of fibromyalgia and ME/CFS and significantly impact quality of life. Aetiology is poorly defined but dysfunctional inflammatory, autonomic and interoceptive (sensing of internal bodily signals) processes are implicated.

To investigate how altered interoception relates to baseline expression of pain, fatigue and anxiety symptoms in fibromyalgia and ME/CFS and in response to an inflammatory challenge.

Sixty-five patients with fibromyalgia and/or ME/CFS diagnosis and 26 matched controls underwent baseline assessment: pressure-pain thresholds and self-report questionnaires assessing pain, fatigue and anxiety severity. Participants received injections of typhoid (inflammatory challenge) or saline (placebo) in a randomised, double-blind, crossover design, before completing heartbeat tracking tasks. Three interoception dimensions were examined: subjective sensibility, objective accuracy and metacognitive awareness. Interoceptive trait prediction error was calculated as discrepancy between accuracy and sensibility.

Patients with fibromyalgia and ME/CFS had significantly higher interoceptive sensibility and trait prediction error, despite no differences in interoceptive accuracy. Interoceptive sensibility and trait prediction error correlated with all self-report pain, fatigue and anxiety measures, and with lower pain thresholds. Anxiety mediated the positive-predictive relationships between pain (Visual Analogue Scale and Widespread Pain Index), fatigue impact and interoceptive sensibility. After inflammatory challenge, metacognitive awareness correlated with baseline self-reported symptom measures and lower pain thresholds.

This is the first study investigating interoceptive dimensions in patients with fibromyalgia and ME/CFS, which were found to be dysregulated and differentially influenced by inflammatory mechanisms. Interoceptive processes may represent a new potential target for diagnostic and therapeutic investigation in these poorly understood conditions.

No significant relationships.

Early Intervention Services for Early-Phase Psychosis have shown efficacy and effectiveness (Correl C, JAMA). In Pamplona, Spain, there is an Early Intervention Program that has been providing multiprofesional assistance for First Psychotic Patients for the last two years.

The aim of this study is to analize the longitudinal effects of the different interventions in several functional variables: GAF, Occupational State, CGI-CogS, QLS, Sofas and WHODAS II applied to 240 patients during two years of follow-up.

We apply an standard evaluation protocol to every patient at different times: premorbid, initial time and at months 6, 12, 18 and 24. We analyse the data with the SPSS statistical program to see the results in these variables.

The GAF scale shows a decline during the first 6 months, but tends to reach and maintain the premorbid levels after a year of treatment. Regarding baseline, patients with normalized jobs or studies are 60.7%. This percentage persists during the next months of follow-up but decline at the 24th month Both the Whodas and Sofas scale show improvement tends. The QLS results show a progresional improvement in every subcale during the whole time of follow-up.

The Early Intervention Services in Psychosis improve, not only psychopatological dimension but also functional areas, what is important for the whole recovery of First Psychotic Patients.

Mr. X, a 39-year-old man presented to us with a history of alcohol use from the last 12-15 years in a dependence pattern with tolerance, uncomplicated withdrawal symptoms and salience. He was detoxified, given parenteral thiamine supplements and oral lorazepam to reduce withdrawal symptoms. He was contemplating to quit alcohol and thus about 4-5 days after his detoxification, tablet acamprosate 1998 mg/day was added, in three divided dosages. He was discharged after 10 days and had no withdrawal signs or cerebellar deficits. In the next follow-up after two weeks, he reported to be abstinent from alcohol, but now complained of new onset coarse tremors and excessive salivation. He had no other extra pyramidal or cerebellar symptoms, no hepatic or renal dysfunction and no neurological deficits. The Patient had a drooling score of 6 on Drooling Severity and Frequency Scale(DSFS).

Acamprosate and naltrexone are the only two drugs approved by the US Food and Drug Administration for achieving abstinence in patients with Alcohol Dependence Syndrome. Acamprosate is well tolerated and has a few drug interactions. It has a comparatively benign side effect profile which includes diarrhea, intestinal cramps, itching, dizziness, muscle weakness, headache, flatulence, nausea, anxiety, and insomnia. Here we report hypersalivation and coarse tremors as unusual side effects of acamprosate.

Cross-sectional

Here we report hypersalivation and coarse tremors as unusual side effects of acamprosate.

The probable mechanism responsible for this is thought to be acamprosate induced decrease in dopamine release in ventral tegmental area due to diminished glutamate activity.

No significant relationships.

Over half of patients with mental disorders are seen by primary care physicians. However, as for patients with somatic problems, referral to psychiatrists seems to be sometimes necessary.

The present study aimed to identify reasons and difficulties perceived by general practitioners (GP) in mental health referrals.

A cross-sectional web-based survey was conducted between August 22 and September 23, 2020, so that 47 responses of GP were included.

The mean age of respondents was 37.3 years. Their seniority as doctors was 8 years on average. Among them, only 17% attended a post-university psychiatric training. The participants reported that they refer on average 32.5% of patients with mental disorders to psychiatrist: 85.1% to psychiatric hospital, 40.4% to liberal psychiatrists and 21.3% to clinical psychologists. Regarding the reasons for referral to mental healthcare structures, 70.2% of doctors justified their doing so by their insufficient training in mental healthcare; 66% by a need for hospitalization, 57.4% by the presence of delusions, while in 27.7 % of cases, the transfer was carried out at the request of the patient or his family. The difficulties mentioned by GP were patient refusal to consult a psychiatrist (70.2%) and difficulties related to the management delay (44.7%).

Patient and health system factors, as well as physicians experience seem to have important influences on mental health referral. Open communication and ease of consultation with psychiatrists can make the care of patients with mental health problems even more rewarding to the primary care physician.

Digital solutions and interventions for mental health have increasingly been taking place in many societies in the last several decades. There are significant differences among countries due to economical and organizational situations. On the other hand, despite digital gap, there is a significant increase in the use of telepsychiatry and e-mental health applications with the Covid-19 pandemic throughout the world. Experiences of this pandemic times make many opportunities and challenges more apparent in this field. Safety and security, legislation, regulations, good practice standards, evidence based data, ethics and education are several of main areas of needs. EPA with the Council of National Psychiatric Associations (NPAs) is one of the crucial organizations in Europe which may play an important role to work on these challenges and opportunities. EPA-Council of NPAs consists of 44 associations represent psychiatrists (and other mental health workers in some) from 40 European countries. NPAs are crucial organisations in contact with local and national mental health stakeholders; competent in national, local, authentic and cultural issues and sensitivities; and could serve as crucial junctions for Europewide policies and their widespread implementations. Some reflections on challenges and opportunities from the Council of NPAs will be presented, based on a rapid survey and personal communications with presidents and official representatives of NPAs for future perspectives.

No significant relationships.